Healthcare providing organizations, such as hospitals and physician offices, often must verify information regarding healthcare professionals, such as physicians and nurses, for a number of purposes, such as regulatory compliance and determining whether to employ or contract with the healthcare professional. These organizations may also wish to know information relating to the healthcare professional's practice history and qualifications. In addition, healthcare providing organizations must obtain claim information for every privileged or employed medical staff member every two years and maintain these records. Other healthcare related organizations, such as payors and malpractice insurance providers, also need verified healthcare personnel data for making business decisions and complying with regulatory requirements. However, the current process of obtaining and verifying healthcare personnel data is tedious and difficult.
There are no simple systems for consistent and automated data collection from a variety of primary sources of healthcare personnel data that can be shared electronically with appropriate consumers of that data. Instead, a variety of different organizations are managing and maintaining different pieces of the same information about healthcare professionals in different places. This makes consistency and accuracy of data more difficult, and takes more time to manage the information. Organizations end up verifying the same data multiple times, causing waste and inefficiency in the verification process, and introducing greater opportunity for error. In addition, many primary source providers do not have sophisticated technologies for managing and communicating data, nor do they have resources to develop such technology.
Credential verification organizations offer services to gather and provide information for individual healthcare professionals. However, these organizations must contact each primary source provider of data for each individual request to obtain the information and ensure that it is verified and accurate. Moreover, these services only provide a static snapshot of the healthcare professional's information. The data provided is only the currently available information and is not maintained and updated as information regarding the healthcare professional changes. Further, the services fail to capture a variety of other important information, such as treatment outcome data.
The National Practitioner Data Bank (NPDB) and Healthcare Integrity and Protection Bank (HIPDB) capture claims against healthcare professionals made by the government, organizations, or individuals. However, this information in and of itself doesn't provide insight to the quality of the healthcare professional. Only negative incidences are contributed to the data bank, and there is no ability to look at the outcomes of the professional's practice with respect to other professionals providing similar services.
Accordingly, what is needed is a system that provides a comprehensive, integrated healthcare personnel record at a single repository. Additionally, it would be desirable for such a system to allow for the automated, electronic collection and distribution of healthcare personnel data among a wide variety of entities.